Hysteroscopic evaluation and endocrinological aspects of women with müllerian anomalies and oligomenorrhea.

In a prospective study of 28 consecutive patients with oligomenorrhea, two had uterus didelphys, and the incidence of mild müllerian anomalies was 50.0%, assessed by hysterosalpingography (HSG). The objects of the study were (1) to confirm these müllerian anomalies hysteroscopically, (2) to assess the predictive value of an abnormal and a normal fundal contour on the HSG, and (3) to find anamnestic, chromosomal, or hormonal characteristics, if any, for women with oligomenorrhea and müllerian anomalies. Twelve patients underwent HSG followed by hysteroscopy, at which a septum or fundal convexity was confirmed in six out of seven patients in whom HSG had shown a mild to moderate indentation of the fundus, but showed no such sign in any of the five patients in the control group in whom the uterine contours had been normal on the HSG (P less than .01). There were no evident anamnestic, chromosomal, or hormonal characteristics for women having uterine developmental anomalies and oligomenorrhea, but there was a major or minor shift in certain androgenic metabolites in some of the patients in this group. It is concluded that HSG seems of great value in diagnosing uterine septa, but hysteroscopy afforded more precise information concerning the degree of fundal anomaly. Longitudinal, more standardized studies are needed for further elucidation of the etiology of the oligomenorrhea in these patients.